Visual disorders in children with cerebral palsy: the implications for rehabilitation programs and school work

Visual disorders in children with cerebral palsy: the implications for rehabilitation programs and school work

Abstract. Damage to thebrain is the most common cause of visual impairment in children in thedeveloped world, and many children with cerebral palsy are affected. Theseverity varies. Profound visual impairment results from bilateral occipitallobe damage. Visual acuities are frequently impaired but may be within thenormal range. Accommodation is commonly impaired and requires appropriatecorrection. Limitation of the visual fields includes hemianopia due tounilateral damage, and lower visual field impairment due to periventricularwhite matter pathology. Perceptual visual dysfunction includes impaired visualguidance of movement (optic ataxia), associated with impaired visual search andattention, (due to posterior parietal / dorsal stream dysfunction) and impairedrecognition and orientation (due to temporal lobe / ventral streamdysfunction). Impairment of eye movements may also contribute to the clinicalpicture. Structured evaluation of all aspects of visual function, matched toeach child’s condition and construction of an optimal management plan, (whichcan be understood and implemented by everyone looking after and teaching thechild), is needed to ensure that no child with cerebral palsy is inappropriatelydisadvantaged on account of their additional cerebral visual impairment.Key words: Cerebral visual impairment, corticalvisual impairment, vision